Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Abstract

Current knowledge on Leishmania infection after kidney transplantation (KT) is limited. In order to offer a comprehensive guide for the management of post-transplant Leishmaniasis, we performed a systematic review following the latest PRISMA Checklist and using PubMed, Scopus, and Embase as databases. No time restrictions were applied, including all English-edited articles on Leishmaniasis in KT recipients. Selected items were assessed for methodological quality using a modified Newcastle–Ottawa Scale. Given the nature and quality of the studies (case reports and retrospective uncontrolled case series), data could not be meta-analyzed. A descriptive summary was therefore provided. Eventually, we selected 70 studies, describing a total of 159 cases of Leishmaniasis. Most of the patients were adult, male, and Caucasian. Furthermore, they were frequently living or travelling to endemic regions. The onset of the disease was variable, but more often in the late transplant course. The clinical features were basically similar to those reported in the general population. However, a generalized delay in diagnosis and treatment could be detected. Bone marrow aspiration was the preferred diagnostic modality. The main treatment options included pentavalent antimonial and liposomal amphotericin B, both showing mixed results. Overall, the outcomes appeared as concerning, with several patients dying or losing their transplant.

Reactivation of cutaneous leishmaniasis after kidney transplantation in the Brazilian Amazon: a case report

“…In 2022, Favi et al 12 carried out a systematic review of the epidemiological and clinical aspects of Leishmania sp. infection in patients undergoing kidney transplantation, and noted that most patients developed leishmaniasis as a late post-transplant complication.…”

“…In 2022, Favi et al 12 . carried out a systematic review of the epidemiological and clinical aspects of Leishmania sp.…”

Mucosal Relapse of Visceral Leishmaniasis in a Child with SARS-CoV-2 Infection

“…Cases of recurrence with mucosal localization in patients previously treated for VL have been described mostly in adult populations with an impaired immune system (HIV+, organ transplant, immunosuppressive therapy) [ 19 , 22 , 24 , 25 ].…”

Advancement in Leishmaniasis Diagnosis and Therapeutics

“…Finally, the special topic presents a systematic review of aspects of leishmaniasis in kidney transplant patients [ 16 ] and a review of the diagnosis and treatment in patients with leishmaniasis from Romania [ 17 ]. Both are important since general readers do not very often access this information.…”